European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 07, Issue 2, 2020
Tooth Mobility
Author Details
1. Dr. S. Sindhuja
Post Graduate,
Department Of Periodontics,
Sree Balaji Dental College And Hospital,
Chennai.
Email [email protected]
Ph- 9500677187.
2. Dr. Anitha Balaji
Professor,
Department Of Periodontics,
Sree Balaji Dental College And Hospital,
Chennai.
Email
[email protected] Ph-9840017004.
ABSTRACT
INTRODUCTION:
Mobility is defined as the degree of looseness of the tooth. All teeth have a slight degree of
physiologic mobility which varies for different teeth & at different times of the day. It is greatest on
arising in the morning & progressively decreases.
Types Of Tooth Mobility:
1. Physiologic tooth mobility
2. Pathologic tooth mobility
1. PHYSIOLOGIC TOOTH MOBILITY: It refers to a moderate force exerted on the crown
of tooth surrounded by a healthy & intact periodontium & tooth will show tipping movement
until a closer contact has been established between root & marginal bony tissue.
2. PATHOLOGIC TOOTH MOBILITY: Mobility beyond the physiologic range is termed
abnormal or pathologic tooth mobility. It is pathologic in that it exceeds the limits of normal
mobility values.
CAUSES OF TOOTH MOBILITY:
1. Loss of alveolar bone
2. Trauma from occlusion
3. Periodontal surgery-JCP vol- 44
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European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 07, Issue 2, 2020
4. Pathological process of the jaws(Osteomyelitis)
5. Orthodontic causes
6. Pregnancy
1 Loss of alveolar bone: Severity depends upon root morphology size & shape. A tooth
with short, tapered roots is more likely to loosen than one with normal or bulbous
roots with same amount of bone loss.
2 Trauma from occlusion: It is a common cause of mobility which occurs initially as a
result of cortical layer resorption leading to reduced fibre support & widened
periodontal space.
3 Orthodontic causes: Orthodontic treatment makes use of weak & strong occlusal forces to
move the teeth for a better alignment. Braces exert force on the teeth to help make the teeth
more mobile which doesnot stop even after the removal of it. Deep bite,bruxism,edge to edge
contacts.
OTHER CAUSES: Pathologic processes of the jaws that destroys the alveolar bone(osteomyelitis).
Mobility is also increased during pregnancy.
STAGES OF TOOTH MOBILITY:
1. INITIAL STAGE: Tooth moves within the confines of the periodontal ligament. Force applied
is about 100lb & is of the order 0.05-0.10mm
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European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 07, Issue 2, 2020
2. SECONDARY STAGE: Increased horizontal forces may cause elastic deformation of the
alveolar bone. Force applied is 500lbs & crown displacement is 100-200 microns for
incisors,50-90 microns for canines,8-10 microns for premolars & 40-80 microns for molars.
METHODS OF ASSESSING MOBILITY:
1. MANUAL METHOD: Force is applied in the Buccolingual direction.
2. MECHANICAL METHOD: Mobilometer, periodontometer measures the reaction of
the periodontium to a defined percussion force applied to the tooth via a tapping
measurement.
TOOTH MOBILITY INDICES:
Miller’s Index 1950
1. Score 0-no detectable mobility
2. Score 1-distinguishable tooth mobility
3. Score 3-movement of more than 1mm in any direction
Glickman’s/Carranza Index
1. Grade 0-normal tooth mobility
2. Grade 1-slightly more than normal
3. Grade 2-moderately more than normal
4. Grade 3-severe mobility faciolingually & mesiodistally combined with the vertical
displacement
Grace And Smales Index
1. Grade 1-mobility <1mm buccolingually
2. Grade 2-mobility 1-2mm buccolingually
3. Grade 3-mobility >2mm buccolingually and or vertical tooth mobility
TREATMENT:
1. Occlusal Adjustment-Known as selective grinding is done to recover the desired
occlusion prior to processing. Modification of occlusal surfaces of teeth through grinding.
It is done to reduce traumatic forces to teeth that exhibit increasing mobility or fremitus.
2. Splinting: It is a procedure by which a tooth resistance to an applied force, is increased
by joining it to a neighboring tooth or teeth. Most common indication to splint mobile
teeth is to improve patient comfort.
3. Regenerative Procedures
BONE GRAFTS: Autografts-bone obtained from same individual
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European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 07, Issue 2, 2020
1. Allografts-bone obtained from different individual of the same species
2. Xenografts-bone from different species
NON BONE GRAFT MATERIALS-sclera,cartilage,plaster of paris,ceramics,coral derived
materials.
Guided Tissue Regeneration: GTR is a method of prevention of epithelial migration along the
cemental wall of the pocket &maintaining space for clot stabilization.For example,
Polytetrafluoroethylene(PTFE)membranes are used.
CONCLUSION:
Mobility is a challenging condition & the treatment has to be done to regenerate the periodontium.
Therefore we as periodontists should preserve & stabilize the natural teeth.
REFERENCES:
1. Clement Chinedu Azodo, Paul Erhabor-Management of tooth mobility in the
periodontology clinic: An overview and experience from a tertiary healthcare setting;
African Journal of Medical and Health Sciences 2016.
2. Paul Fotek, Debby Hwang, Ilona Fotek: Tooth mobility and its interpretations; J Soc
Periodontal 2007.
3. Giargia M, Lindhe J: Tooth Mobility and periodontal disease; J Clin Periodontal 1997.
4. Carranza 11th Edition.
5. J Lindhe 6th Edition.
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